This study aimed to evaluate the knowledge and concerns of 124 dental health professionals in southern India regarding COVID-19. A survey was administered to assess understanding of COVID-19 transmission, oral manifestations, appropriate testing and emergency procedures. The results found good knowledge of COVID-19 and precautions, but some lack of awareness regarding appropriate testing and managing contaminated air. While most respondents understood transmission risks and emergency protocols, there was uncertainty around testing patients and using mouthwashes as prevention. This highlights gaps in knowledge that could be addressed with further education for dental professionals on COVID-19 clinical guidelines.

1. S448 © 2021 Journal of Pharmacy and Bioallied Sciences | Published by Wolters Kluwer - Medknow
Aim: This study was intended to evaluate the knowledge and apprehension of
dental health professionals pertaining to COVID‑19. Materials and Methods: In
this cross‑sectional survey, a self‑administered questionnaire survey was used to
validate the dental health professional’s knowledge and apprehension pertaining
to COVID‑19. In this regard, a preliminary study with a convenience sample of
124 dentists working in various clinics in southern India was conducted so as
to evaluate the knowledge and apprehension of dentists related to COVID‑19 in
India. This study, while limited in sample size, benefits the general practitioners
as target readers to assess the awareness pertaining to COVID‑19. Results: The
results of this study reveal that there exists a good knowledge among dental
health professionals pertaining to the COVID‑19 virus and its oral manifestations
in addition to the precautions to be taken for the prevention of COVID‑19 in a
clinical setup. However, there exists an apprehension as well as lack of awareness
pertaining to the laboratory test to be carried out in a patient suspected with
COVID‑19 infections as well as the role of a mouthwash and the management of
contaminated air in the dental clinic. Conclusion: The results elicited that there
is a dearth of knowledge and relatively a fair apprehension among dental health
professionals pertaining to COVID‑19.
Keywords: COVID‑19, dentists, oral manifestations
Knowledge and Apprehension of Dental Health Professionals Pertaining
to COVID in Southern India: A Questionnaire Study
Izna, Venkata Krishna Sasank Kuntamukkula1
, Shilpa Sunil Khanna2
, Onkar Salokhe3
, Rahul Vinay Chandra Tiwari4
,
Heena Tiwari5
Access this article online
Quick Response Code:
Website: www.jpbsonline.org
DOI: 10.4103/jpbs.JPBS_551_20
Address for correspondence: Dr. Izna,
Department of Microbiology, Government Medical College
and Associated Hospital, Rajouri, Jammu and Kashmir, India.
E‑mail: driznamb@gmail.com
the spread of infection from a patient to a dentist or
dental assistant is high.[3]
The incubation period of this
virus ranges from 2 to 14 days, with a mean of 5 or
6 days. and nearly four in five virus‑positive patients
could turn out to be asymptomatic.[4,5]
Literature reveals
that maxillofacial surgeons and otorhinolaryngologists in
addition to dentists are at high risk for COVID‑19.[6,7]
Introduction
It is a well‑known fact that the novel coronavirus
(nCoV) is a unique virus that affected human beings
by causing severe respiratory disease and is responsible
for a high fatality rate globally.[1]
Based on the currently
available literature, it is understood that the virus spreads
through the airborne transmission.[2]
The most frightening
pandemic the world has faced in over a century poses
a great threat to health‑care workers, particularly
dental health professionals. Since handpieces, airwater
syringes, and ultrasonic scalers generate a significant
volume of aerosols in the working area, dentists are
surely at a greater risk. Therefore, the likely chance for
Department of Microbiology,
Government Medical College
and Associated Hospital,
Rajauri, Jammu and Kashmir,
1
Department of Oral and
Maxillofacial Surgery, Sri Sai
College of Dental Surgery,
Vikarabad, Telangana,
2
Department of Oral and
Maxillofacial Surgery, Sri
Ramakrishna Dental College
and Hospital, Coimbatore,
Tamil Nadu, 3
Department of
Orthodontics and Dentofacial
Orthopeadics, Vasantdada
Patil Dental College, Sangli,
Maharashtra, 4
Department
of OMFS, Narsinbhai Patel
Dental College and Hospital,
Sankalchand Patel University,
Visnagar, Gujarat, 5
BDS,
PGDHHM, CHC, Makdi,
Chhattisgarh, India
Submitted: 22‑Sep‑2020
Revised: 23-Sep-2020
Accepted: 24‑Sep‑2020
Published: 05-Jun-2021.
Abstract
This is an open access journal, and articles are distributed under the terms of the
Creative Commons Attribution‑NonCommercial‑ShareAlike 4.0 License, which allows
others to remix, tweak, and build upon the work non‑commercially, as long as
appropriate credit is given and the new creations are licensed under the identical
terms.
For reprints contact: WKHLRPMedknow_reprints@wolterskluwer.com
How to cite this article: Izna, Sasank Kuntamukkula VK, Khanna SS,
Salokhe O, Chandra Tiwari RV. Knowledge and apprehension of
dental health professionals pertaining to COVID in Southern India: A
questionnaire study. J Pharm Bioall Sci 2021;13:S448-51.
Original Article
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2. S449
Journal of Pharmacy and Bioallied Sciences ¦ Volume 13 ¦ Supplement 1 ¦ June 2021
Izna, et al.: Dental health professionals & COVID 19
This necessitates the formulation of novel protocols to
warrant the operator and patient safety. Therefore, this
study was planned.
Materials and Methods
A cross‑sectional survey was undertaken to evaluate
the knowledge and apprehension of dental health
professionals pertaining to COVID‑19 in India. The
study included 124 dentists performing clinical practice
in various clinics belonging to different parts of southern
India. Most of the participants had a postgraduate
qualification and specialists in their field of clinical work
while few were general dentists. Before commencing the
study, an Institutional Ethical Committee clearance was
obtained. Ethical approval for this study was provided
by the Government Medical College and Associated
Hospital, Rajouri (Regd No.: 677/ODCHRC/RB‑E/2020)
on March 12, 2020. A self‑administered questionnaire
with 13 questions was distributed via Google Forms to
the E‑mails of these dental health professionals. The
questionnaire was sent to approximately 200 consultants,
but unfortunately, only 124 responded even after
repeated reminders. The participants were instructed
to answer the questionnaire very precisely without any
descriptions. Dental health professionals were instructed
to answer the questionnaire using either the right or
wrong options, as shown in Table 1. After collecting the
filled questionnaires, participants were given instructions
about COVID-19 related to precautions, contamination
etc. and all their doubts were cleared. Survey questions
were aimed to assess the facts whether the dental health
professional is totally aware of the COVID‑19, oral
manifestations that occur in a suspected patient with
COVID‑19 infection, laboratory test to be carried out in a
patient suspected with COVID‑19 infections, emergency
and nonemergency dental procedures to be carried out at
this need of the hour, and precautions for prevention of
COVID‑19 in a clinical setup. The survey forms were
evaluated and critically analyzed.
Results
The results of this study showed that 87.9% of the
respondents were aware of the COVID‑19, but only
77.77% of the respondents were totally aware of its
oral manifestations. 80.6% of the respondents were
aware that dentists are at the highest risk for COVID‑19
infections than any other professional. 92.7% of the
respondents were aware of the incubation period. 100%
of the respondents have not encountered any patient with
suspected oral manifestations of COVID‑19. However,
only 32.25% of the respondents knew the laboratory test
to be carried out in a patient suspected with COVID‑19
infections. It was observed that 90.32% of the
respondents were totally aware of the difference between
the emergency and nonemergency dental procedures to
be carried out at this need of the hour. Almost all of the
respondents follow a proper biomedical waste disposal
in their clinical setup. Nearly 94.35% of the respondents
were aware as to which dental procedure generates
the maximum bioaerosol in a dental clinic, thereby
increasing the risk of contamination. Unfortunately,
only 62.09% of the respondents were aware of how to
manage contaminated air in the dental clinic and 42% of
the respondents were aware of the ideal mouthrinse to
be advised before any dental procedure for prevention of
contamination from COVID‑19. The results of this study
reveal that there exists a good knowledge among dental
health professionals pertaining to the COVID‑19 virus
and its oral manifestations in addition to the precautions
to be taken for the prevention of COVID‑19 in a clinical
setup. However, there exists an apprehension as well
as lack of awareness pertaining to the laboratory test to
Table 1: The questionnaire used in the study
Type of questions
1. Are you totally aware of COVID-19?
2. Do you think dental health professionals are at highest risk?
3. Do you know the incubation period for human-to-human transmission?
4. Are you totally aware of the oral manifestations of COVID-19?
5. Have you encountered any patient with suspected oral manifestations of COVID-19?
6. Have you taken total precautions for prevention of COVID-19 in your clinical area?
7. Do you know the laboratory test to be carried out in a patient suspected with COVID-19 infections?
8. Do you follow complete infection control protocol in carrying out your clinical work?
9. Are you totally aware of the difference between the emergency and nonemergency dental procedures to be carried out at this need of the
hour?
10. Do you follow proper biomedical waste disposal?
11. Are you aware as to which dental procedure generates the maximum bioaerosol in a dental clinic?
12. Do you know how to manage contaminated air in your dental clinic?
13. Do you know the ideal mouthrinse to be advised before any dental procedure for prevention of contamination from COVID-19?
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3. S450 Journal of Pharmacy and Bioallied Sciences ¦ Volume 13 ¦ Supplement 1 ¦ June 2021
Izna, et al.: Dental health professionals & COVID 19
be carried out in a patient suspected with COVID‑19
infections as well as the role of a mouthwash and the
management of contaminated air in the dental clinic. The
results obtained for the study are depicted in Table 2.
Discussion
Bioaerosols are considered to be biological particles
suspended in gaseous media.[8]
It is a well‑known fact
that a subgingival scaling using an ultrasonic scaler
in the management of periodontally week teeth can
produce aerosols.[9,10]
These bioaerosols are dangerous
for dentists.[11]
Therefore, this study was planned. The
results of this study show that 94.35% of the respondents
were aware that subgingival scaling would generate more
aerosols compared to other dental procedures. 90.32%
of the respondents were aware of the emergency and
nonemergency dental procedures to be carried out at
this need of the hour. A recent study emphasized that
equivalent precedence is needed for infection control
protocols in dental setup.[12]
The results of this study
reveal that 91.12% of the respondents follow complete
infection control protocol in carrying out their clinical
work. It is desirable to employ extraoral radiographs
such as orthopantomographs or oblique lateral views
as an alternative to intraoral radiographs for screening
in patients with sensitive gag reflex.[13,14]
A rubber dam
should be used for dental treatment.[15]
Literature has
shown that SARS and MERS are extremely susceptible
to Betadine rinse.[16,17]
The results of this study reveal
that 41.12% of the respondents were unaware of this
fact. Antiretraction high‑speed dental handpiece should
be used.[18]
A well‑ventilated dental clinic can reduce the
amount of contaminated air by venting the exhaust air
and also by avoiding the recirculation of contaminated
air.[19]
Disinfecting the surfaces following each patient
visit is essential.[20]
The results of this study show that
62.09% of the respondents were unaware of how to
manage contaminated air in their clinic. However, 91.12%
of the respondents follow complete infection control
protocol in carrying out their clinical work. Biomedical
waste is an infectious medical waste.[16]
The results of
this study show that 94.35% of the respondents follow
proper biomedical waste disposal. It was clearly evident
since COVID‑19 epidemic, elective surgeries in the
maxillofacial region progressively decreased worldwide
in order to prevent risk. The same trend continued in
India as well. A recent study noticed a huge reduction
of outpatient visits (−87%) and outpatient (−86%) and
inpatient surgical procedures (−78%) within 4 weeks
after the beginning of the pandemic.[21]
Conclusion
Our results clearly reveal that there is a dearth of
knowledge and relatively a fair apprehension among
dental health professionals pertaining to COVID‑19.
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
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